In the middle of her pregnancy, 21-year-old Parthenia Cade-Goodle agreed to let a nurse visit her at home for weekly coaching sessions. At first, Parthenia says, her expectations were low.
Fast forward a few months, and things have changed dramatically. Today, Parthenia calls her nurse, a woman named Barbara Behrendt, her “best friend.”
“She’s really important to me,” Parthenia says. “Next to my mom, it’s Barb.”
Parthenia’s a client at Nurse Family Partnership, a national anti-poverty program that works by targeting and pouring resources into early childhood in order to save money down the road. The program pairs trained nurses with first-time, vulnerable moms – most of them young, single and low-income – to support them during their first two years of motherhood. To qualify, clients must have a total household income that’s at or below 185 percent of the federal poverty level.
For Parthenia and her nurse, the bi-weekly home visits are part therapy, part training, part unwinding on the couch with Parthenia’s 2-month-old boy, Addesso.
“It’s that relationship that makes this program different from others,” Barbara says. “Because it allows us that trust with each other to work on goals, develop those goals, and work towards a future.”
As a program, Nurse Family Partnership is centered squarely on the relationship between client and nurse. The home visits start at some point before the 28th week of pregnancy, so a client can acclimate to her nurse before the baby’s even in the picture. The visits then continue all the way until the baby’s second birthday.
With every visit, nurses help clients achieve goals they set for themselves, rather than the other way around.
“My wants and needs for my clients don’t really matter,” Barbara says, underscoring a key philosophical pillar of this program. “It’s what they want to do with their lives.”
Today, Barbara and Parthenia are celebrating. That’s because Parthenia is on track to achieve one of her most important goals: breastfeeding her son for his first year of life. Parthenia says she’s grown to love breastfeeding because it’s such an intimate experience.
“I like that I’m the only person that can feed Addesso,” she says. “No one else can feed him.”
Beyond breastfeeding, Barbara’s coaching Parthenia on a range of topics you may not necessarily expect for a nurse. These include how to save the money she earns from her job as a security guard, how to manage her time with work, chores and a new baby, and how to integrate other family members into caring for Addesso.
They cover nutrition, from the major food groups to how to buy healthy groceries. Down the road, Barbara will teach Parthenia the basics of toddler development – what to expect and encourage at 3 months, 6 months, 1 year and so on, so Addesso’s on track for healthy growth. They’ll cover crawling, walking and potty training.
At the end of the day, the goal is to help Parthenia and Addesso become a healthy, self-sufficient family – and guide Parthenia to plan life around not just herself, but her baby, too.
“If we can get parents to center their goals around the baby, the baby’s development, the baby’s physical needs and emotional needs, and really work on those goals up until the age of 2, it kind of sets children up for a lifetime of healthy living and emotional states and healthy developments,” Barbara says.
Parthenia lives at her mom’s place in Zion, Illinois, and this program is run out of the Lake County Health Department. It started here just a year and a half ago, so it’s still too early to gauge results. But researchers have studied NFP closely over the years and nationally it has an impressive track record.
Randomized trials show NFP reduces child abuse and neglect by 48 percent. Language delays for children at 21 months drop by 50 percent. Behavioral and intellectual problems at age 6 drop by 67 percent. Kids in the program even suffer fewer accidental injuries that take them to the ER.
The impact transcends early childhood, spilling over into later stages of life. As children served by the program grow up, research shows a 26 percent rise in their math and reading test scores in first through third grades. There’s a 59 percent drop in arrests of teenagers at age 15, and a 20 percent drop in welfare use.
Patricia Donald helps run Nurse Family Partnership in Lake County, where NFP serves about 70 families. She points to a recent study by the PEW Center that explores the program’s financial impact. According to PEW Center, society saves approximately $9.50 for every $1 spent on NFP (taking into account a wide range of factors, such as savings from special education, criminal justice and government assistance, as well as wage gains and health benefits).
“To invest on the front end is way better than to try and catch the house while it’s burning,” Patricia says.
According to her, the model works thanks to realistic expectations.
“We’re not going to see poster child experiences on every occasion,” she says. “But I think the better perspective is to understand where a person has come from, and any gains are positive. Some young women have been dealing with so much trauma and difficulty in their life that for them to hold down a job is a major gain... or that they’re responding positively to this child they didn’t think they wanted. All of those we would see as gains in the program even though it’s not our ideal.”
So far, NFP operates in six counties in Illinois, serving 360 families in total. Across the country, the program serves almost 24,000 families.
For Barbara, the program represents a small, targeted effort that can yield major results.
“People complain often about single mothers not doing enough to take care of themselves and their children,” Barbara says. “From what I’m seeing, they just need that little push... I think this is the wave of the future.”
For now, Barbara and Parthenia are trying hard to focus on the present. But the clock is ticking. When Addesso turns 2, this program concludes and their home visits will stop.
“I don’t want it to end,” Parthenia says. “I really think as he grows older, she could be somebody that’ll be a really good influence on him. And she’s a really good influence on me. So that’s going to be really heartbreaking.”
Parthenia hopes to continue with a program like this – not just necessarily on the receiving end. Right now, she's looking into becoming a nurse herself.
“At first, I wanted to be a nurse,” Parthenia says. “But I wasn’t quite so sure, like grounded. But honestly, after meeting Barb and Barb being in my life, I know that’s where I need to be.”